Addie Meedom House, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ADDIE MEEDOM HOUSE, LLC

Practice address

1445 Parkway Dr
Crescent City, CA 95531-8021

Phone

(707) 464-3311

NPI assigned

Apr 22, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joh Harder

Title

Manager

Phone

(503) 485-4600

Specialties & licenses 1

Addresses

Other names 1

• ADDIE MEEDOM HOUSE Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669690244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 FAIRVIEW INDUSTRIAL DR SE",
            "address_2": "270",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021177",
            "telephone_number": "503-485-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 PARKWAY DR",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318021",
            "telephone_number": "707-464-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDIE MEEDOM HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARDER",
        "authorized_official_first_name": "JOH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-485-4600"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADDIE MEEDOM HOUSE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Crescent City, CA
• Providers in Crescent City, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.